Impact of renal transplantation on erectile dysfunction due to chronic renal failure in male patients.

BACKGROUND: Erectile dysfunction can be defined as the persistent inability of man to achieve penile erection and maintain it sufficient for satisfactory coitus. The objectives of this study were to find out the impact of successful renal transplantation on the degree and frequency of erectile dysfunction. METHODS: Thirty patients of end stage renal disease that were on regular haemodialysis and candidates of renal transplantation of age range 20-55 years were included in the study after getting informed consent. Erectile functions were assessed by history, examination, investigations and international index of erectile function (IIEF) before and 3 and 6 months after renal transplantation, other information regarding disease and patient were collected in the performa. RESULTS: Out of thirty patients 14 (46.6%) patients had sever erectile dysfunction while 16 (53.3%) patients had moderate erectile dysfunction in the pre renal transplantation period. After three months of renal transplantation 15 (50%) had severe erectile dysfunction, 6 (20%) patients moderate erectile dysfunction and 9 (30%) patients mild erectile dysfunction. After six months 11 (36.6%), 10 (33.3%) and 8 (26.6%) patients had severe, moderate and mild erectile dysfunction respectively. CONCLUSION: There was improvement in 40%, no change in 53.3% and deterioration in 6.6% patients in the erectile functions after getting renal transplantation for end stage renal disease.

Role of digital rectal examination and prostate specific antigen in detecting carcinoma prostate.

OBJECTIVE: To investigate the ability of digital rectal examination (DRE) and prostate specific antigen (PSA) in detecting carcinoma prostate. DESIGN: Descriptive cross-sectional study. PLACE AND DURATION OF STUDY: The study was conducted in the Department of Urology and Renal Transplantation from December 1996 to December 1999. PATIENTS AND METHODS: Two hundred patients entered the protocol. They presented with complaint of prostatism or retention of urine. The patients were evaluated with estimation of serum prostate specific antigen and digital rectal examination was performed. Prostatic tissue biopsy was also done. RESULTS: Digital rectal examination has shown sensitivity of 63% and specificity of 73.22%. The sensitivity of PSA was 87% and specificity was 70.8%. The positive predictive value for DRE and PSA was 57.5% and 78.04% respectively. Negative predictive value was 73.22% and 85.22% respectively. P value was statistically significant <0.037. In the second part of study a baseline serum PSA level in age-matched 200 patients without history of prostatism was estimated. CONCLUSION: It was concluded that PSA represent an important adjunct to DRE for detection of prostate carcinoma.

Bilateral gangrene of lower limbs in a neonate.

Limb gangrene in a neonate is an extremely rare clinical problem and bilateral symmetrical lower limbs type is even rarer. Only few clinical cases have been reported thus far with idiopathic etiology or associated with rare conditions. Known causes in literature are sepsis, extravasation of intravenous fluid, following a complicated delivery and secondary to invasive monitoring. This report describes neonate was first developed sepsis and later was exposed to cold leading to bilateral gangrene of lower limbs.